Epidural Analgesia and Fever

To the Editor.—

We read the article by Goetzl et al¹ with interest. While we agree that there is an association between epidural analgesia and increased maternal temperature,² we would question that epidural analgesia in the mother per se leads to increased screening for sepsis in the newborn whether the mother is febrile or afebrile after an epidural.

At St Helier Hospital we have reviewed 461 consequent deliveries. In this audit we noted the following irrespective of whether the mothers received epidural analgesia or not: parity, mode of delivery, time from membrane rupture to birth, duration of first and second stage, maternal temperature on arrival in the delivery suite, maternal temperature during labor, if there was any other reason (eg, infection) to explain maternal pyrexia, infant’s temperature immediately after birth, if the infant received a sepsis screen, if the infant was prescribed antibiotics, and if the infant developed within the first 7 days after birth.

At our institution women are also given the choice to choose epidural analgesia. Midwives and obstetricians may also recommend this option for a labor that seems more painful than normal or has an increased risk of surgical delivery or in the presence of certain medical disorders, such as preeclampsia. If they choose epidural analgesia they are given bupivacaine 0.1% with …